BEIRUT/ANKARA: Turkey’s military and its rebel allies have encircled the northern Syrian city of Afrin, the Turkish armed forces said Tuesday, a substantial advance in Ankara’s offensive against Kurdish fighters across its southern border.

In a statement, the military said it had completely encircled the city, home to some 350,000 people and defended by a well-armed Syrian Kurdish militia, the People’s Protection Units (YPG).

Birusk Hasakeh, a YPG spokesman inside Afrin, denied the city had been totally besieged but said the last route leading out of it was being shelled heavily.

The Syrian Observatory for Human Rights said Turkish forces were within firing range of that route, which leads to a pair of regime-held towns – essentially encircling Afrin and 90 villages to its west.

It remains unclear what Turkey’s next move will be, but it may lay siege to Afrin while allowing civilians to leave to avoid a high-casualty offensive.

Abu Jaafar, a commander in the pro-Ankara forces waging Operation Olive Branch, said rebels were considering leaving an “exit route” for civilians. “We will allow civilians ... to leave so they will not be hurt in case [Kurdish] fighters hold out in the villages, neighborhoods, or buildings inside Afrin,” he told AFP.

Meanwhile, sick and wounded civilians left a rebel enclave in Eastern Ghouta under the first medical evacuation since one of the deadliest assaults of the 7-year-old war began nearly a month ago.

Women carrying infants, men hobbling on crutches and an old man in a wheelchair waited at a school near the Al-Wafideen crossing, along with dozens who exited the enclave through it, a witness said.

The government’s tactic of offering safe passage to rebels who agree to surrender territory played out Tuesday nearby in Qadam, south of the capital, one of the few areas near Damascus apart from Eastern Ghouta still in opposition hands.Hezbollah’s War Media Center said buses had transported around 300 fighters from the Ajnad al-Sham group and their families to rebel-held Idlib province in the north.

Qadam is surrounded by government-held territory on one side and neighborhoods controlled by Daesh (ISIS) on the other. The Observatory said there was fighting between government forces and Daesh militants in that area.

Yasser Delwan, a political official with the Jaish al-Islam rebel faction, said the patients who left the town of Douma Tuesday were the first of several groups and were on a U.N. list of nearly 1,000 people needing emergency treatment.

State media said others followed the first group, which included about 35 people. They would go to a shelter nearby on the outskirts of Damascus.

Meanwhile, troops pressed on with their offensive and took farmland around the town of Jisreen, the War Media Center reported.